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Organization
MOORE ORTHOPAEDIC CLINIC, P.A.
Active
Organization
MOORE ORTHOPAEDIC CLINIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SEAN MCNALLY (CEO)
(803) 227-8152
Entity
Organization
Contact information
Practice address
THE PLEX, 741 FASHION DRIVE, COLUMBIA, SC 29229
(803) 227-8005
Mailing address
PO BOX 843384, BOSTON, MA 02284-3384
(803) 227-8000
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0497990001
MEDICARE DMERC PROVIDER #
SC
01
—
DM0194
MEDICAID DME PROVIDER #
SC
05
—
PA0686
—
SC
Enumeration date
08/23/2006
Last updated
08/22/2020
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